Acute Urinary Retention

1
Acute Urinary Retention

• Aetiology
• Causes of urinary retention are numerous and can
  be classified as1
• In men - benign prostatic hyperplasia (BPH),
  meatal stenosis, paraphimosis, penile
  constricting bands, phimosis, prostate cancer.
• In women - prolapse (cystocele, rectocele,
  uterine), pelvic mass (gynaecological malignancy,
  uterine fibroid, ovarian cyst), retroverted
  gravid uterus.
• In both - bladder calculi, bladder cancer, faecal
  impaction, gastrointestinal or retroperitoneal
  malignancy, urethral strictures, foreign bodies,
  stones

2
Infectious and inflammatory

• In men - balanitis, prostatitis and prostatic
  abscess.
• In women - acute vulvovaginitis, vaginal lichen
  planus and lichen sclerosis, vaginal pemphigus.
• In both - bilharzia, cystitis, herpes simplex
  virus (particularly primary infection),
  peri-urethral abscess, varicella-zoster virus.

3
Neurological

• Autonomic or peripheral nerve (eg, autonomic
  neuropathy, diabetes mellitus, Guillain-Barré
  syndrome, pernicious anaemia, poliomyelitis,
  radical pelvic surgery, spinal cord trauma, tabes
  dorsalis).
• Brain (eg, cardiovascular disease (CVD), multiple
  sclerosis (MS), neoplasm, normal pressure
  hydrocephalus, Parkinson's disease).
• Spinal cord (eg, invertebral disc disease,
  meningomyelocele, MS, spina bifida occulta,
  spinal cord haematoma or abscess, spinal cord
  trauma, spinal stenosis, spinovascular disease,
  transverse myelitis, tumours, cauda equina).

4
Differential diagnosis

• AUR is usually painful, whilst slowly obstructing
  pathological processes tend to be relatively
  pain-free.
• Prostatic hyperplasia may be associated with
  obstruction uropathy that is relatively painless
  but frequently comes to light when a superimposed
  acute obstruction occurs preventing effective
  urination ('acute-on-chronic' urinary retention).
  For about 50 of those with AUR, the acute
  retention was their first symptom of underlying
  prostatic hyperplasi

5
Best Treatment of Frequent or urgent urination
6
Click here to know morewww.uridoc.info
7
THANK YOU